CAJ | 학술논문

目的：探讨胱氨酸蛋白酶抑制剂C（ Cystatin C）与老年痴呆患者认知功能障碍、脑萎缩和脑灌注之间的相关关系，分析老年痴呆患者Cystatin C水平变化的可能机制。方法对61例男性和55例女性老年痴呆患者进行生化分析，检测Cystatin C、Urea、β2微球蛋白和Cr指标，用3．0T磁共振对脑部成像，测量海马体积、Evans指数，利用磁共振动脉自旋标记灌注成像技术对患者脑血流灌注情况成像，通过图像处理并测量脑灌注水平，采用MMSE量表和MoCA量表对痴呆患者行认知功能评定。结果血清中Cysta?tin C水平在男女老年痴呆患者中存在明显差别[男：（0．95±0．20）mg／L，女：（1．32±0．41）mg／L]（ P＝0．04）。对于男性患者，年龄和Cystatin C与海马体积[（6157．14±355．58）mm3]、Evans指数（0．33±0．02）、MMSE评分[（21．66±7．97）分]、MoCA评分[（21．96±6．19）分]之间存在相关关系（年龄：P＝0．040，0．049，0．035，0．039；Cystatin C：P＝0．035，0．038，0．037，0．035），对于女性患者，仅年龄与海马体积[（6319．53±377．74） mm3]、Evans指数（0．31±0．02）、MMSE评分[（22．93±6．22）分]、MoCA评分[（23．41±8．20）分]之间存在相关关系（ P＝0．044，0．045，0．047，0．046）。男性患者Cystatin C与脑灌注成像指标之间存在明显相关关系（ r＝－0．78， P＝0．034），女性患者不存在相关关系（P＝0．086）。结论男女老年痴呆患者Cystatin C水平存在明显差别，Cystatin C水平可能能够作为预测男性老年痴呆患者认知功能障碍程度和脑灌注水平指标之一。
목적：탐토광안산단백매억제제C（ Cystatin C）여노년치태환자인지공능장애、뇌위축화뇌관주지간적상관관계，분석노년치태환자Cystatin C수평변화적가능궤제。방법대61례남성화55례녀성노년치태환자진행생화분석，검측Cystatin C、Urea、β2미구단백화Cr지표，용3．0T자공진대뇌부성상，측량해마체적、Evans지수，이용자공진동맥자선표기관주성상기술대환자뇌혈류관주정황성상，통과도상처리병측량뇌관주수평，채용MMSE량표화MoCA량표대치태환자행인지공능평정。결과혈청중Cysta?tin C수평재남녀노년치태환자중존재명현차별[남：（0．95±0．20）mg／L，녀：（1．32±0．41）mg／L]（ P＝0．04）。대우남성환자，년령화Cystatin C여해마체적[（6157．14±355．58）mm3]、Evans지수（0．33±0．02）、MMSE평분[（21．66±7．97）분]、MoCA평분[（21．96±6．19）분]지간존재상관관계（년령：P＝0．040，0．049，0．035，0．039；Cystatin C：P＝0．035，0．038，0．037，0．035），대우녀성환자，부년령여해마체적[（6319．53±377．74） mm3]、Evans지수（0．31±0．02）、MMSE평분[（22．93±6．22）분]、MoCA평분[（23．41±8．20）분]지간존재상관관계（ P＝0．044，0．045，0．047，0．046）。남성환자Cystatin C여뇌관주성상지표지간존재명현상관관계（ r＝－0．78， P＝0．034），녀성환자불존재상관관계（P＝0．086）。결론남녀노년치태환자Cystatin C수평존재명현차별，Cystatin C수평가능능구작위예측남성노년치태환자인지공능장애정도화뇌관주수평지표지일。
Objective To explore the correlationship between Cystatin C and the cognitive dysfunction, encephalatrophy and the cerebral perfusion in Alzheimer's disease ( AD ) patients, and to analyze the probable mechanisms of the Cystatin C level alterations. Methods For the 61 male and 55 female AD patients,the levels of Cystatin C,Urea,Cr andβ2?microglobulin were detected by biochemistry analysis.The hypocampus volume and Ev?ans index were measured by MRI imaging. The cerebral perfusion was evaluated by magnetic resonance perfusion imaging of arterial spin labeling technique and image processing. The cognitive level of AD patients was done by MMSE scale and MoCA scale. Results The Cystatin C levels in serum of male AD patients were dramatically dif?ferent from female AD patients(male:(0.95±0.20)mg/L,female:(1.32±0.41)mg/L)(P=0.04). For male AD patients,age and Cystatin C had a correlationship among the hypocampus volume((6157.14±355.58)mm3),Evans index(0.33±0.02),MMSE score(21.66±7.97),and MoCA score(21.96±6.19)(age:P=0.040,0.049,0.035, 0.039;Cystatin C:P=0.035,0.038,0.037,0.035),but for female only age((79.52±8.82)years) had a correla?tionship with the hypocampus volume((6319.53±377.74)mm3),Evans index(0.31±0.02),MMSE score(22.93± 6.22),and MoCA score(23.41±8.20)(P=0.044,0.045,0.047,0.046). For male AD patients,the marked correla?tionship was showed between Cystatin C and the index of cerebral perfusion(P=0.034),but for female patients, there's no correlationship(P=0.086) . Conclusion The Cystatin C level is distinctly different in male and female AD patients. The Cystatin C level in male AD patients maybe be an index to predict the degree of the cognitive dys?function and the level of cerebral perfusion.